The MD/PhD Training Program at Oregon Health & Science University (OHSU) offers integrated medical and scientific training. Graduate programs include Biochemistry and Molecular Biology, Physiology and Pharmacology, Genetics, Cell and Developmental Biology, Molecular Microbiology and Immunology, Cancer Biology, Neuroscience, Behavioral Neuroscience, Biomedical Engineering and Biomedical Informatics. In addition, with the opening of our new School of Public Health offering PhDs in 1) Epidemiology, 2) Community Health, and 3) Health Systems and Policy. Substantial differences in curricula for both the MD and PhD programs (compared with those for straight MD or PhD students) are in place, and include elimination of several required classes and one clerkship in the MD curriculum, and elimination of the requirement for three research rotations for the graduate programs. In addition to several graduate school courses that our MD/PhD students are excused from, a system is in place to allow our students to challenge any required graduate school course by achieving a satisfactory score on the final exam. To tailor the graduate curriculum appropriately for the individual, a Scientific Oversight Committee of three faculty is assigned to each student. We have also added several courses specific to the MD/PhD program, including a required 5 - 6 week Clinical/Translational Research Clerkship (housed in our CTSA funded Oregon Clinical and Translational Research Institute) and a required Longitudinal Clinical Rotation, providing a formalized, mentored ongoing clinical experience two half days a month during the PhD years. Extensive student tracking and mentorship programs are in place. Our monthly MD/PhD Grand Rounds, presented by physician scientists on our faculty and taking the form of a case based introduction to a scientific talk, assures ongoing exposure to clinical and translational research, and the guidelines for our weekly MD/PhD Journal Club require that the article be placed firmly in a clinical context in the background presented. Our annual MD/PhD Research Retreat also features talks by OHSU scientists, many of whom have translational research projects, as well a keynote speaker of international reputation, selected for the clinical relevance as well as quality of his or her research. We foste public speaking skills, providing multiple opportunities for student presentations, with formal feedback from the Program Director. We also emphasize grant writing skills, providing multiple sources of assistance in crafting and submitting individual NRSA and similar grants from professional societies, with a very high rate of success in achieving funding. Our new medical school curriculum provides added flexibility with respect to the timing of reentry into the MD program, and should avoid students taking more than 7 - 8 years to complete the program except in exceptional cases. With the strong support of the Dean of the School of Medicine as well as the Oregon Clinical and Translational Research Institute and the Departments and Faculty as a whole, we provide an ideal environment for training the next generation of physician scientists.